Provider Demographics
NPI:1760105662
Name:BARNETT, CAROL JOAN (LLMSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JOAN
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:JOAN
Other - Last Name:SMITHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:883 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-1449
Mailing Address - Country:US
Mailing Address - Phone:313-720-4300
Mailing Address - Fax:
Practice Address - Street 1:3 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-1282
Practice Address - Country:US
Practice Address - Phone:734-627-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851114911104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker